Transcript Presentation 1 - National Healthy Homes Conference

Radon and Healthy
Housing: What’s
Happening Now, What’s
in Store for the Future
Bill Long
US EPA
Acknowledgements
•
Antonio Neri MD, MPH
•
•
Medical Epidemiologist
CDC Comprehensive Cancer Control Branch
• R. William Field, PhD, MS
• Professor, Department of Occupational and
Environmental Health
• Department of Epidemiology, College of Public Health,
University of Iowa
• Phil Jalbert
• US EPA radon program
Radon
Decay
Products
Radon-222
4 day
a,g
Polonium-218
3 min
a,g
Lead-214
27 min
b,g
Bismuth-214
20 min
b,g
Polonium-214
Po-218 and Po-214
deliver the majority
of radiation dose to
the lung.
0.2 ms
a,g
Lead-210
22 yrs
b,g
Bismuth-210
b,g
5 day
Polonium-210 138 day
a,g
Lead-206
Stable
Ionizing radiation can directly and
indirectly damage DNA
Alpha
Particle
Defects in tumor suppressor
genes – p53
At risk individuals–GSTM1
(glutathione S-transferase M1)
Reading
Prong
From NCRP Report No. 160, “Ionizing
Radiation Exposure of the Population of the
United States” (2009)
U.S. Radon Potential

Based on geology and
surveys

Expected closed
building radon (pCi/L):
Zone 1: 4.0 and above
Zone 2: between 2.0 &
4.0
Zone 3: 2.0 and lower
EPA Radon Action Level 4 pCi/L
National Academy of Sciences
BEIR VI 1999
• Risk estimates based
primarily on radonexposed miners
• Estimated 18,600 lung
cancer deaths each
year in the U.S. from
residential radon
exposure
BEIR VI Conclusions
 Serious public health problem
 Second-leading cause of lung cancer
 No evidence of a threshold
 Effects of Radon & Smoking more powerful in
combination
 Radon contributed to 15K or 21K US lung
cancer deaths in 1995 [2,100 or 2,900 in never
smokers].
 Reduction of residential radon levels above 4
pCi/L could prevent approx. 1/3 of the annual
Residential Radon Case-Control
Around the World
European Studies
North American Studies
13 Studies from 9 Countries
• Austria
• Czech Republic
• Finland [nationwide]
• Finland [south]
• France
• Germany [eastern]
• Germany [western]
• Italy
• Spain
• Sweden [nationwide]
• Sweden [never
smokers]
• Sweden [Stockholm]
• United Kingdom
• 7 Studies from 2 countries:
• New Jersey
• Winnipeg
• Missouri I [non-smoking
women]
• Missouri II [women]
• Iowa
• Connecticut
• Utah-South Idaho
•
Total 3,622 cases and 4,966 controls
In 2003, the EPA
updated the BEIR VI risk
estimates to 21,000
radon-related lung
cancer deaths each year
in the United States.
http://www.epa.gov/radon/risk_assessment.html
EPA Radon
Assessment Results
 Modified & extended the NAS BEIR VI report
[consultation with SAB and NAS panel
members]
 Best estimate of US population risk in homes is
about 21,000 lung cancer deaths per year. [At
US average indoor radon conc.]
 Current Risks at Action Level
 Smokers
6/100
 Never Smokers
7/1000
CA: A Cancer Journal for Clinicians
Volume 64, Issue 1, pages 9-29, 7 JAN 2014 DOI: 10.3322/caac.21208
http://onlinelibrary.wiley.com/doi/10.3322/caac.21208/full#caac21208-fig-0001
Cancer Statistics 2014
CANCER MORTALITY – 2014
CANCER TYPE
1. Lung and Bronchus
2. Colon and Rectum
3. Breast Cancer
4. Pancreas
5. Prostate
6. Leukemia
7. Liver and Bile Duct
8. Lymphoma
9. Urinary Bladder
10. Esophagus
11. Ovary
12. Kidney and Renal Pelvis
13. Myeloma
14. Stomach
15. Melanoma - skin
ESTIMATED U.S. DEATHS in 2014
159,260
50,310
40,430
39,590
29,480
24,090
23,000
20,170
15,580
15,450
14,270
13,860
11,090
10,990
9,710
CANCER MORTALITY – 2014
CANCER TYPE
1. Lung and Bronchus
2. Colon and Rectum
3. Breast Cancer
4. Pancreas
5. Prostate
6. Leukemia
7. Liver and Bile Duct
Radon- Induced Lung Cancer
8. Lymphoma
9. Urinary Bladder
10. Esophagus
11. Ovary
12. Kidney and Renal Pelvis
13. Myeloma
14. Stomach
15. Melanoma - skin
ESTIMATED U.S. DEATHS in 2014
159,260
50,310
40,430
39,590
29,480
24,090
23,000
21,000
20,170
15,580
15,450
14,270
13,860
11,090
10,990
9,710
Toxic Substances Control Act (TSCA)
Title III (1988)
Indoor Radon Abatement Act (IRAA)
• Section 306. Grant Assistance to States for Radon Programs
• Governor Designates the Recipient
• Recipient can be a Department, Agency or State Institution,
e.g., University
• EPA Responsibilities Delegated to Regional Administrators &
Assistant Administrator for OAR
17
EPA Radon Program
21,000 Radon-related U.S. Lung Cancer Deaths Annually
Leading Environmental Cause of Cancer Mortality
Long-term Exposure to 1.25 pCi/L
Average Indoor Radon Level in U.S. Homes
7,083,000
Homes ≥4pCi/L
2 ways to reduce risk: mitigate high homes; build homes
radon-resistant
18
Radon
•
•
•
•
Interventions
• ≤ $20 / test, $300 – $2,000 remediate
• < $250 – $750 to build radon resistant homes
EPA $8 million to state radon programs/yr
• education, testing, remediation, policy-related radon activities
Intervention = ↓ exposure
• Vent air from under house
• Seal basement cracks
Laws
• 28 states + DC have laws specific to radon
•
•
Req. testing, Req. Disclosure, Voluntary Testing
Radon-Resistant New Construction
o Int’l Building Code adoption
Website: http://sktelokkalong.co.cc/buy-radon-test-kit
States with Radon-specific Cancer Activities
2005 – 2011
Tribes and Territories with Radon-specific Cancer Plan Activities include: Alaska Native Tribal Healthcare Corporation, Fon du Lac Tribe,
Northern Plains Native American Tribal CCC Program, Tohono O'odham Tribe, and Guam.
Note that Alaska, Hawaii, and DC do not have radon-specific cancer plan activities
States with Radon-specific Laws in 2014 *
* Washington, DC has one radon-specific law. The ELI database does not review or track radon laws for tribes
Annual Radon-related Lung Cancer Deaths
2000
1800
1600
1724
1465 1441
1400
1160
1200
960
1000
900
822
800
693
675
668
668
628
604
600
593
600
576
564
551
503
488
435
399
391
IA
AL AZ
400
367
200
0
CA PA OH
IL
NY
IN
GA TN NJ
FL VA MA MD KY TX
State
16-20 Draft
MI MN MO CO WI NC
Annual Radon-related Lung Cancer Deaths
350
322
305
300
296
250
221
203 199 197
200
169
146
150
125 123
119 115 113 112
102
100
95
92
83
82
74
64
49
50
38
33
20
14
0
CT WA KS SC NE WV ME OR NM LA MT NV AR MS OK ID
State
17-20 Draft
RI NH SD UT ND WY DE AK VT HI DC
Progress on Risk
Reduction
7.1M Homes ≥4pCi/L
Mitigate existing homes (2 – 4 pCi/L)
•
•
•
•
1,244,000 mitigation systems installed since 1986
9,100 lives saved (lung cancer deaths avoided)
1,542 mitigated homes saves 1 life
Multi-pronged demand/supply strategy
(partnerships [ELI, CRCPD, NCSL, NEHA, KSU],
PSAs,
real estate, home inspection, stakeholder trainings)
24
State Indoor Radon Grant
(SIRG) Program
• 45 states participating
• 5 Not
Participating
(NH, MD, LA, AR,
Philip
Jalbert
HI) 343.9431,
[email protected]
http://www.epa.gov/radon/sirgpr
ogram.html
• Tribes: FY2013 10 Awards =
$304,000
Federal Radon Action Plan
• Federal leadership required to accelerate action on
radon risk reduction – a key Healthy Homes concern
• An example of Inter-Agency Collaboration (USDA,
DOD, DOE, EPA, GSA, HHS, HUD, DOI, VA)
• A special focus on families and low income communities
Framework for Federal Action:
Our Areas of Focus
• Demonstrate Importance of radon risk
reduction
• Provide Incentives to encourage testing and
mitigation
• Build Demand for testing and mitigation
Key Milestones Tracking Our Progress
Nov 2010:
Held Federal Radon Summit where agencies agreed to
develop the Federal Radon Action Plan
Jun 2011:
Launched the Action Plan at the Healthy Homes Conference
Jan 2012:
Released the Action Plan Scorecard
Aug 2012:
Celebrated one-year anniversary at CDC’s National Cancer
Conference in Washington DC
Feb 2013:
Released the Accomplishments Report in conjunction with
the unveiling of the Advancing Healthy Housing – A Strategy
for Action.
Status of Commitments
Agency
Green – Completed
Yellow – On Track
USDA
6
DoD
1
1
DOE
2
2
EPA
1
1
GSA
1
1
HHS
2
1
HUD
3
1
DOI
2
1
VA
1
Multi
1
3
TOTAL
19
12
Red – No Progress
1
1
2
33 Total Commitments
To access Scorecard visit www.epa.gov/radon/action_plan.html
www.epa.gov/radon
Build Demand for Testing & Mitigation
•
•
The Department of Housing and Urban Development (HUD) wrote new radon
testing and mitigation requirements for their multifamily housing mortgage
insurance programs, estimated to reach 105,000 housing units in 2013.
The Environmental Protection Agency (EPA) is investing in 4 new standards
of practice. New provisional standard for radon mitigation in multifamily housing
released this year.
Provide Incentives to Encourage Testing and Mitigation
•
The Department of Agriculture (USDA) issued new secretary-level guidance to
all of its field office housing, community, loan (~301K this year), and public
information programs to promote radon mitigation and new construction.
Demonstrate the importance of radon testing & mitigation
•
The Department of Health and Human Services reported that 27 CDC
sponsored state five-year cancer plans now include radon, representing 41%
of existing cancer plans.
– Of that total, two cancer programs have included radon activities for the
first time and two have expanded radon activities within their plans.
Moving Forward: Leadership,
Leverage and Visibility
Priorities for the Near-term Future
•
•
•
•
•
•
Federal Radon Action Plan (FRAP)
Allied Leaders
Partnerships with NGOs
Standards of Practice
Code adoption
Labelling programs
34